The Phenomenon of Exquisite Motor Control in Tic Disorders and its Pathophysiological Implications

The unifying characteristic of movement disorders is the phenotypic presentation of abnormal motor outputs, either as isolated phenomena or in association with further clinical, often neuropsychiatric, features. However, the possibility of a movement disorder also characterized by supranormal or enhanced volitional motor control has not received attention. Based on clinical observations and cases collected over a number of years, we here describe the intriguing clinical phenomenon that people with tic disorders are often able to control specific muscle contractions as part of their tic behaviors to a degree that most humans typically cannot. Examples are given in accompanying video documentation. We explore medical literature on this topic and draw analogies with early research of fine motor control physiology in healthy humans. By systematically analyzing the probable sources of this unusual capacity, and focusing on neuroscientific accounts of voluntary motor control, sensory feedback, and the role of motor learning in tic disorders, we provide a novel pathophysiological account explaining both the presence of exquisite control over motor output and that of overall tic behaviors. We finally comment on key questions for future research on the topic and provide concluding remarks on the complex movement disorder of tic behaviors

Toward Optimizing Risk Adjustment in the Dutch Surgical Aneurysm Audit

Background: To compare hospital outcomes of aortic aneurysm surgery, casemix correction for preoperative variables is essential. Most of these variables can be deduced from mortality risk prediction models. Our aim was to identify the optimal set of preoperative variables associated with mortality to establish a relevant and efficient casemix model.Methods: All patients prospectively registered between 2013 and 2016 in the Dutch Surgical Aneurysm Audit (DSAA) were included for the analysis. After multiple imputation for missing variables, predictors for mortality following univariable logistic regression were analyzed in a manual backward multivariable logistic regression model and compared with three standard mortality risk prediction models: Glasgow Aneurysm Score (GAS, mainly clinical parameters), Vascular Biochemical and Haematological Outcome Model (VBHOM, mainly laboratory parameters), and Dutch Aneurysm Score (DAS, both clinical and laboratory parameters). Discrimination and calibration were tested and considered good with a C-statistic &gt; 0.8 and Hosmer-Lemeshow (H-L) P &gt; 0.05. Results: There were 12,401 patients: 9,537 (76.9%) elective patients (EAAA), 913 (7.4%) acute symptomatic patients (SAAA), and 1,951 (15.7%) patients with acute rupture (RAAA). Overall postoperative mortality was 6.5%; 1.8% after EAAA surgery, 6.6% after SAAA, and 29.6% after RAAA surgery. The optimal set of independent variables associated with mortality was a mix of clinical and laboratory parameters: gender, age, pulmonary comorbidity, operative setting, creatinine, aneurysm size, hemoglobin, Glasgow coma scale, electrocardiography, and systolic blood pressure (C-statistic 0.871). External validation overall of VBHOM, DAS, and GAS revealed C-statistics of 0.836, 0.782, and 0.761, with an H-L of 0.028, 0.00, and 0.128, respectively.Conclusions: The optimal set of variables for casemix correction in the DSAA comprises both clinical and laboratory parameters, which can be collected easily from electronic patient files and will lead to an efficient casemix model.</p

Effects of yeast combined with chromium propionate on growth performance and carcass quality of finishing steers

Citation: Vanbibber-Krueger, C. L., Axman, J. E., Gonzalez, J. M., Vahl, C. I., & Drouillard, J. S. (2016). Effects of yeast combined with chromium propionate on growth performance and carcass quality of finishing steers. Journal of Animal Science, 94(7), 3003-3011. doi:10.2527/jas2016-0454A combination of yeast and chromium propionate (Y+Cr) was added to the diets of crossbred finishing steers (n = 504; 402 kg ± 5.76 initial BW) to evaluate impact on feedlot performance and carcass traits. We hypothesized supplementation of Y+Cr would increase growth of feedlot steers. Steers with initial plasma glucose concentrations ?6.0 mM were stratified by initial BW and randomly allocated, within strata, to receive 0 (control) or 3.3 g/d Y+Cr. Steers were further divided into heavy and light weight blocks with 6 pens/diet within each weight block. Cattle were housed in dirt-surfaced pens with 21 steers/pen and had ad libitum access to feed. Body weights were measured at 21-d intervals. Blood samples were collected on d 49 and 94 from a subset of steers (5/pen) for analyses of plasma glucose and lactate concentrations. At the end of the finishing phase, animals were weighed and transported 450 km to an abattoir in Holcomb, KS. Severity of liver abscesses and HCW were collected the day of harvest, and after 36 h of refrigeration, USDA yield and quality grades, LM area, and 12th rib subcutaneous fat thickness were determined. There were no treatment × time × weight block interactions (P > 0.05) and no treatment × block interaction for ADG, DMI, or final BW (P ? 0.06), but a treatment × block interaction (P = 0.03) was observed for G:F, in which control, light cattle had poorer efficiency compared with other groups. Treatment × weight group interactions were observed for overall yield grade and carcasses that graded yield grade 1 (P ? 0.04). Light steers supplemented with Y+Cr had decreased overall yield grade and increased percentage of carcasses grading yield grade 1 compared with their control counterparts, with no differences observed for heavy steers. Regardless of weight group, a greater percentage of carcasses from steers supplemented with Y+Cr graded yield grade 2 (P = 0.03) and fewer carcasses from steers supplemented Y+Cr graded yield grade 3 (P 0.10). Overall, yeast in combination with chromium propionate may improve feed efficiency and decrease yield grade of light cattle but had no effect on remaining carcass traits and blood constituents. © 2016 American Society of Animal Science. All rights reserved

Flake Density, Roll Diameter, and Flake Moisture All Influence Starch Availability of Steam-Flaked Corn

Steam-flaked corn is commonly fed in feedlot finishing diets because steam-flaking improves starch availability and nutrient utilization, thus improving the overall feeding value of corn. In most operations which utilize steam-flaked corn, grain is processed to a pre-determined flake density by setting the rolls to a specific separation distance and using tension to hold rolls together. Flaked grain is most often produced to a bulk density between 24 and 32 lb/bu, with a common recommendation of 27 lb/bu for corn; however, flake density among steam-flakers within a single mill and among feedlots can vary greatly. Flaking to a similar density using 2 flakers does not ensure similar starch availability. The degree of starch gelatinization or starch availability of steam-flaked corn can be estimated using analytical procedures such as enzymatic hydrolysis, gas production, and steam-flaked corn gelatinization methods. Routinely evaluating starch availability is used as a quality control method to standardize the steam-flaking process to ensure within-day and day-to-day manufacturing consistency. The concentration of readily available starch in steam-flaked corn is indicative of the rate of starch fermentation in the rumen. When starch is too readily available and is fermented at an excessively rapid rate, acid can accumulate in the rumen, reducing ruminal pH, and ultimately resulting in increased prevalence of digestive disturbances. Factors that contribute to variation between feedlot operations with respect to steamflaked corn quality include type and dimensions of flaking equipment, grain type, grain variety and moisture content, roll wear, and steam-flaking procedures. Sampling and handling procedures contribute to precision of results; therefore, sampling procedures need special attention, and consistency must be evaluated when attempting to determine starch availability of steam-flaked corn. The objective of this study was to evaluate starch availability of steam-flaked corn comparing roll dimensions and steam-flaked corn flake densities among flaking systems and feedyards and to provide information on the equipment utilized, steam-flaked corn flaking procedures, and to define current manufacturing practices of steam-flaking in commercial feedlot operations

The Use of Bioelectrical Impedance to Assess Shelf-Life of Beef Longissimus Lumborum Steaks

Objective: The objective of this study was to evaluate the efficacy of using surface and internal bioelectrical impedance to assess beef longissimus lumborum shelf-life during 15 days of simulated retail display. Study Description: Beef strip loins, obtained from three commercial processors (postmortem age = 27, 34, or 37 days), were fabricated into 12 1-inch thick steaks. Steaks were subdivided into six consecutively cut pairs, packaged on Styrofoam trays, overwrapped with polyvinyl chloride film, and displayed under fluorescent lighting at 32–40°F in coffin-style retail cases for 15 days. Microbiological analysis, pH, bioelectrical impedance analysis, objective color assessment, proximate composition, and lipid oxidation were measured. Surface and internal bioelectrical impedance assessment were compared. The Bottom Line: Internal bioelectrical impedance has potential for use to assess shelf-life of retail steaks and it was more precise than surface bioelectrical impedance; however, internal bioelectrical impedance may translocate bacteria into the muscle. Protein degradation and water holding capacity should be evaluated to better understand bioelectrical impedance changes over time

Relationship Between Trauma Sustained at Unloading and Carcass Bruise Prevalence in Finished Cattle at Commercial Slaughter Facilities

Bruising in cattle can be an indicator of poor animal welfare, as well as a significant cause of economic loss due to decreased carcass value. Previous literature suggests sources of trauma causing bruising in beef carcasses include horn prevalence, rough transport conditions, cattle handling techniques, cattle temperament, and vehicle design; however, evidence of correlations between such trauma and actual carcass bruising is limited. The objective of this study was to evaluate the relationship between trauma sustained at unloading and carcass bruise prevalence in finished cattle at commercial slaughter facilities

Beef Longissimus Lumborum Steak pH Affects External Bioelectrical Impedance Assessment

Objective: To use external bioelectrical impedance analysis to assess postmortem chemical changes in normal- and high-pH beef longissimus lumborum steaks during simulated retail display. Study Description: Beef strip loins (n = 20; postmortem age = 14 d) obtained from a commercial processor were sorted into two treatments, normal-pH (5.61–5.64; n = 11) and high-pH (6.2–7.0; n = 9). Loins were fabricated into five 1-inch thick steaks (n = 100), and randomly assigned to one of five display days: 1, 3, 5, 7, and 9. External bioelectrical impedance values, oxygen consumption, metmyoglobin reducing ability, protein degradation, water holding capacity, and pH were assessed on each storage day. The Bottom Line: External bioelectrical impedance is a method that could be used to separate normal- and high-pH strip loins with potential for rapid, in-plant use to identify dark-cutting beef

Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA):Study protocol for a randomized controlled trial

BACKGROUND: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines mechanical endothelial damage, using a rotating wire, with the infusion of a liquid sclerosant. Tumescence anesthesia is not required. Preliminary experiences with MOCA showed good results and low post-procedural pain. METHODS/DESIGN: The MARADONA (Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation) trial is a multicenter randomized controlled trial in which 460 patients will be randomly allocated to MOCA or RFA. All patients with primary GSV incompetence who meet the eligibility criteria will be invited to participate in this trial. The primary endpoints are anatomic and clinical success at a one-year follow-up, and post-procedural pain. The secondary endpoints are technical success, complications, operation time, procedural pain, disease-specific quality of life, time taken to return to daily activities and/or work, and cost-efficiency analyses after RFA or MOCA. Both groups will be evaluated on an intention to treat base. DISCUSSION: The MARADONA trial is designed to show equal results in anatomic and clinical success after one year, comparing MOCA with RFA. In our hypothesis MOCA has an equal anatomic and clinical success compared with RFA, with less post-procedural pain. TRIAL REGISTRATION: Clinicaltrials NCT0193616

A supplement containing multiple types of gluconeogenic substrates alters intake but not productivity of heat-stressed Afshari lambs

Citation: Mahjoubi, E., Amanlou, H., Yazdi, M. H., Aghaziarati, N., Noori, G. R., Vahl, C. I., . . . Baumgard, L. H. (2016). A supplement containing multiple types of gluconeogenic substrates alters intake but not productivity of heat-stressed Afshari lambs. Journal of Animal Science, 94(6), 2497-2505. doi:10.2527/jas2015-9697Thirty-two Afshari lambs were used in a completely randomized design with a 2 x 2 factorial arrangement of treatments to evaluate a nutritional supplement designed to provide multiple gluconeogenic precursors during heat stress (HS). Lambs were housed in thermal neutral (TN) conditions and fed ad libitum for 8 d to obtain covariate data (period 1 [P1]) for the subsequent experimental period (period 2 [P2]). During P2, which lasted 9 d, half of the lambs were subjected to HS and the other 16 lambs were maintained in TN conditions but pair fed (PFTN) to the HS lambs. Half of the lambs in each thermal regime were fed (top-dressed) 100 g/d of a feed supplement designed to provide gluconeogenic precursors (8 lambs in HS [heat stress with Glukosa {HSG}] and 8 lambs in PFTN [pair-fed thermal neutral with Glukosa]) and the other lambs in both thermal regimes were fed only the basal control diet (HS without Glukosa [HSC] and pair-fed thermal neutral without Glukosa). Heat stress decreased DMI (14%) and by design there were no differences between the thermal treatments, but HSG lambs had increased DMI (7.5%; P < 0.05) compared with the HSC lambs. Compared with PFTN lambs, rectal temperature and skin temperature at the rump, shoulder, and legs of HS lambs were increased (P < 0.05) at 0700 and 1400 h. Rectal temperature at 1400 h decreased for HSG lambs (0.15 +/- 0.03 degrees C; P < 0.05) compared with HSC lambs. Despite similar DMI between thermal treatments, ADG for HS and PFTN lambs in P2 was decreased 55 and 85%, respectively, compared with lambs in P1 (P < 0.01). Although the prefeeding glucose concentration was not affected by thermal treatment or diet, HSG lambs had increased postfeeding glucose concentration compared with HSC lambs (P < 0.05). In contrast to the glucose responses, circulating insulin was influenced only by thermal treatment; HS lambs had increased insulin concentration (P < 0.01) before feeding and decreased concentration (P < 0.05) after feeding compared with PFTN lambs. Heat-stressed lambs had decreased NEFA concentration before feeding (P < 0.01) but not after feeding relative to PFTN lambs. Although this nutritional strategy did not affect ADG, the lower rectal temperature in HSG lambs indicates that dietary inclusion of a mixture of glucogenic precursors can potentially benefit animal health during HS